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Aspects of Self-harm - Cognition, Imaging and Treatability

Recruiting
Conditions
Non-Suicidal Self Injury
Personality Disorders
Self-Harm, Deliberate
Attempt Suicide
Interventions
Diagnostic Test: Emotional Stop Signal Task
Diagnostic Test: Magnetic Resonance Imaging
Other: World Health Organizations Disability Assessment Schedule (WHODAS 2.0)
Diagnostic Test: Personality Inventory for DSM-5 (PID-5)
Diagnostic Test: Stop Signal Task (CANTAB)
Diagnostic Test: Intra-Extra Dimensional Set Shift (CANTAB)
Diagnostic Test: Spatial Working Memory Test (CANTAB)
Diagnostic Test: Multitasking Test (CANTAB)
Diagnostic Test: Cambridge Gambling Task Test
Registration Number
NCT04905797
Lead Sponsor
Region Skane
Brief Summary

Deliberate self-harm (DSH) is a common symptom in psychiatric disorders. This study aim at increased understanding of parameters associated with DSH with the long term goal to potentially improve and possibly personalise its treatment.

In short, the study will characterise cognitive, psychiatric and demographic factors with focus on executive function and will compare results from individuals with DSH, individuals who have ceased DSH as well as psychiatric patients without DSH and individuals who never engaged in DSH. Adequate statistical tests will be used to compare groups.

Participants will be interviewed by a trained physician for basic medical history, history of self-harm and treatment for that, demographic data and diagnostic evaluation. Thereafter the participants will undergo standardised neuropsychological testing focusing on emotional response inhibition, decision making and risk taking, attention set shifting, working memory, inhibition and planning. Some participants will redo parts of this testing during fMRI, as well as undergo DTI and volumetry.

Detailed Description

Deliberate self-harm (DSH) is a common symptom in psychiatric disorders. Today, there is not sufficient knowledge as to why an individual continues to suffer from DSH, DSH is reduced or even ceased - regardless given treatment or not. The overall aim of this project is to characterise cognitive, psychiatric and demographic factors as well as perform brain imaging in individuals currently suffering from DSH, individuals with a prior history of DSH, individuals with psychiatric disease but no DSH and healthy individuals. The intention is to gain more knowledge on factors associated with DSH and thereby potentially improve and possibly personalize treatment.

The following hypotheses will be tested:

Individuals currently suffering from DSH have lower scores on executive function than individuals with a prior history of DSH, individuals with psychiatric disease but no DSH and healthy individuals.

Individuals currently suffering from DSH have lower level daily life functioning and more severe psychiatric symptoms than individuals with a prior history of DSH, individuals with psychiatric disease but no DSH and healthy individuals.

Individuals currently suffering from DSH have higher scores of negative affectivity, lower scores of antagonism and lower scores of disinhibition measured with Personality Inventory for DSM-5 than individuals with a prior history of DSH, individuals with psychiatric disease but no DSH and healthy individuals.

Individuals currently suffering from DSH have, when executing the neurocognitive tests in hypothesis 1, a significant lower blood flow in the prefrontal network, than individuals with a prior history of DSH, individuals with psychiatric disease but no DSH and healthy individuals.

Individuals currently suffering from DSH have a decrease in local cerebral white matter compared to individuals with a prior history of DSH, individuals with psychiatric disease but no DSH and healthy individuals.

Material:

The aim is to recruit 300 participants in total, 75 participants to each group:

1. individuals with psychiatric disorders and persistent DSH

2. individuals with psychiatric disorders who have ceased DSH

3. individuals with psychiatric disorders who never had DSH

4. healthy controls who never had DSH

Participants will be interviewed by a trained physician for basic medical history, history of self-harm and treatment for that, demographic data and diagnostic evaluation. Thereafter the participants will undergo standardised neuropsychological testing focusing on emotional response inhibition, decision making and risk taking, attention set shifting, working memory, inhibition and planning. Some participants will redo parts of this testing during fMRI, as well as undergo DTI and volumetry.

Recruitment & Eligibility

Status
RECRUITING
Sex
All
Target Recruitment
300
Inclusion Criteria

Not provided

Exclusion Criteria

Not provided

Study & Design

Study Type
OBSERVATIONAL
Study Design
Not specified
Arm && Interventions
GroupInterventionDescription
Clinical cases who ceased self-harmMagnetic Resonance ImagingIndividuals with psychiatric disorders who have ceased DSH
Deliberate self-harmMagnetic Resonance ImagingIndividuals with psychiatric disorders and persistent DSH
Deliberate self-harmEmotional Stop Signal TaskIndividuals with psychiatric disorders and persistent DSH
Deliberate self-harmPersonality Inventory for DSM-5 (PID-5)Individuals with psychiatric disorders and persistent DSH
Deliberate self-harmStop Signal Task (CANTAB)Individuals with psychiatric disorders and persistent DSH
Deliberate self-harmWorld Health Organizations Disability Assessment Schedule (WHODAS 2.0)Individuals with psychiatric disorders and persistent DSH
Deliberate self-harmMultitasking Test (CANTAB)Individuals with psychiatric disorders and persistent DSH
Clinical cases who ceased self-harmWorld Health Organizations Disability Assessment Schedule (WHODAS 2.0)Individuals with psychiatric disorders who have ceased DSH
Clinical cases with no self-harmCambridge Gambling Task TestIndividuals with psychiatric disorders who never had DSH
Healthy controlsEmotional Stop Signal TaskHealthy controls who never had DSH
Deliberate self-harmSpatial Working Memory Test (CANTAB)Individuals with psychiatric disorders and persistent DSH
Deliberate self-harmCambridge Gambling Task TestIndividuals with psychiatric disorders and persistent DSH
Clinical cases who ceased self-harmEmotional Stop Signal TaskIndividuals with psychiatric disorders who have ceased DSH
Clinical cases who ceased self-harmPersonality Inventory for DSM-5 (PID-5)Individuals with psychiatric disorders who have ceased DSH
Deliberate self-harmIntra-Extra Dimensional Set Shift (CANTAB)Individuals with psychiatric disorders and persistent DSH
Clinical cases who ceased self-harmStop Signal Task (CANTAB)Individuals with psychiatric disorders who have ceased DSH
Clinical cases who ceased self-harmIntra-Extra Dimensional Set Shift (CANTAB)Individuals with psychiatric disorders who have ceased DSH
Clinical cases who ceased self-harmMultitasking Test (CANTAB)Individuals with psychiatric disorders who have ceased DSH
Clinical cases who ceased self-harmCambridge Gambling Task TestIndividuals with psychiatric disorders who have ceased DSH
Clinical cases with no self-harmPersonality Inventory for DSM-5 (PID-5)Individuals with psychiatric disorders who never had DSH
Clinical cases who ceased self-harmSpatial Working Memory Test (CANTAB)Individuals with psychiatric disorders who have ceased DSH
Clinical cases with no self-harmWorld Health Organizations Disability Assessment Schedule (WHODAS 2.0)Individuals with psychiatric disorders who never had DSH
Healthy controlsWorld Health Organizations Disability Assessment Schedule (WHODAS 2.0)Healthy controls who never had DSH
Healthy controlsStop Signal Task (CANTAB)Healthy controls who never had DSH
Clinical cases with no self-harmEmotional Stop Signal TaskIndividuals with psychiatric disorders who never had DSH
Clinical cases with no self-harmMagnetic Resonance ImagingIndividuals with psychiatric disorders who never had DSH
Clinical cases with no self-harmStop Signal Task (CANTAB)Individuals with psychiatric disorders who never had DSH
Clinical cases with no self-harmIntra-Extra Dimensional Set Shift (CANTAB)Individuals with psychiatric disorders who never had DSH
Clinical cases with no self-harmMultitasking Test (CANTAB)Individuals with psychiatric disorders who never had DSH
Healthy controlsMagnetic Resonance ImagingHealthy controls who never had DSH
Healthy controlsIntra-Extra Dimensional Set Shift (CANTAB)Healthy controls who never had DSH
Clinical cases with no self-harmSpatial Working Memory Test (CANTAB)Individuals with psychiatric disorders who never had DSH
Healthy controlsPersonality Inventory for DSM-5 (PID-5)Healthy controls who never had DSH
Healthy controlsSpatial Working Memory Test (CANTAB)Healthy controls who never had DSH
Healthy controlsMultitasking Test (CANTAB)Healthy controls who never had DSH
Healthy controlsCambridge Gambling Task TestHealthy controls who never had DSH
Primary Outcome Measures
NameTimeMethod
Executive functioningUp to 1 hour

Scores on cognitive tests measuring executive functioning

VolumetryUp to 1 hour

Volumes of local cerebral white matter

Level of function in daily life30 days

Scores on WHODAS 2.0

Personality traitsMore than 1 year (stable)

Scores on Personality Inventory for DSM-5

Blood flowUp to 1 hour

Blood flow in prefrontal cortex during neurocognitive tests

Secondary Outcome Measures
NameTimeMethod

Trial Locations

Locations (1)

Psykiatri och habilitering, Region SkĂĄne

🇸🇪

Lund, SkĂĄne, Sweden

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